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Immediately after the countdown ends and the race begins, the kart drivers are launched into the pinball machine. After that, the racers start a descent down the machine, encountering numerous pinballs on the way. These pinballs may collide with a kart, causing the vehicle to be knocked backwards. Additionally, a racer will lose any items he or she may be carrying. While the racers are in the pinball shooter, they are unaffected by lightning and some other items. Other obstacles include flippers and bumpers. Waluigi Pinball makes a cameo appearance in the Nintendo Monopoly board game. The music theme from the course is also featured in Super Smash Bros. Brawl on the Mario Circuit stage arranged in a enhanced electronic rock style by Kentaro Ishizaka.

The track returns in Mario Kart 7 as the fourth and final course in the Banana Cup. However, Waluigi himself does not appear in the game as a playable character (though he was supposed to appear as a playable character in the game). The launch after the start/finish line now encompasses a gliding pad, although racers cannot move to the left or right while being launched, similar to Wii Maple Treeway and DS Airship Fortress. The jumps after turn 1 and after turn 6 can be used to perform a trick and gain a boost. Racers are now vulnerable to some other items especially lightning. Players may fall to the color stripes, if they cancel the glider or if they are hit by the item at the glider pad or during the launch. If players do fall down, they will get picked up by Luigi and brought back to the end of the launch or the ramp that was very close to the beginning of the pinball shooter. If players failed to cross the gap after a boost panel Luigi will always take the racers back to the end of the gap, instead of taking them back to the beginning of the ramp that was close to the boost panel. Instead if racers touched the flippers, it will trigger an electric effect causing the players to spun around without pushing them far away.

Mario Kart DS European website: "Wario's weird sibling constructed this high-speed track inside a giant pinball table; complete with bumpers, flippers, ramps, and enormous steel spheres that bounce you around like - well, like a pinball. Make sure to bring plenty of aspirin for this race."

The "Waluigi Pinball" music from Super Smash Bros. Brawl has a part where Wario's victory theme is played (from the same game).

When the player runs through an Item Box, goes over a boost pad or completes the first lap, a different, more pinball machine-themed version of the normal sound made plays. This is retained for the Mario Kart 7 version of the track.

In Mario Kart DS, Waluigi Pinball shares the same music with Wario Stadium.

In Mario Kart DS, when pinballs hit off the flippers, their speed increases, then decreases to normal when they go back up to the 4 bumpers. However in Mario Kart 7, the pinball obstacle speed remains constant.